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BackgroundHigher social support protects people from developing mental disorders. Limited evidence is available on the mechanism through which social support plays this protective role.ObjectiveTo investigate the stress-buffering process of social support on depressive symptoms using a novel longitudinal dynamic symptom network approach.MethodsA total of 4242 adult participants who completed the first two waves (from May to October 2020) of the International Covid Mental Health Survey were included in the study. Cross-lagged panel network modelling was used to estimate a longitudinal network of self-reported social support, loneliness and depressive symptoms. Standardised regression coefficients from regularised cross-lagged regressions were estimated as edge weights of the network.FindingsThe results support a unidirectional protective effect of social support on key depressive symptoms, partly mediated through loneliness: A higher number of close confidantsand accessible practical helpwas associated with decreased anhedonia(weight=−0.033) and negative self-appraisalsymptoms (weight=−0.038). Support from others was also negatively associated with loneliness, which in turn associated with decreased depressed mood(weight=0.086) and negative self-appraisal(weight=0.077). We identified a greater number of direct relationships from social support to depressive symptoms among men compared with women. Also, the edge weights from social support to depression were generally stronger in the men’s network.ConclusionsReductions in negative self-appraisal might function as a bridge between social support and other depressive symptoms, and, thus, it may have amplified the protective effect of social support. Men appear to benefit more from social support than women.Clinical implicationsBuilding community-based support networks to deliver practical support, and loneliness reduction components are critical for depression prevention interventions after stressful experiences.

ABSTRACTBackground:Posttraumatic stress disorder (PTSD) is a serious mental disorder, which is associated with emotional and cognitive functioning problems. Psychological interventions, such as trauma-focused cognitive behavioural therapy (tf-CBT) and eye movement desensitization and reprocessing (EMDR) are effective in reducing PTSD symptoms. Despite evidence showing that PTSD is associated with neurocognitive deficits, there is no systematic overview available on neurocognitive outcomes following treatment for PTSD. The current systematic review examined whether psychological treatments for PTSD improve neurocognitive functioning outcomes related to memory, attention, information processing, and executive functioning.Method:A literature search in PubMed, PsycINFO, PTSDpubs, and Cochrane Library was performed up to March 7, 2022, in collaboration with a medical information specialist. Eligible PTSD treatment studies examining neurocognitive outcomes (memory, attention, information processing and executive function) in patients with a DSM-IV or ICD diagnosis of PTSD were included.Results:Of the 3023 titles and abstracts identified, 9 articles met inclusion criteria, of which 5 randomized controlled trials (RCTs) and 4 non-randomized studies. Treatments included were cognitive behavioural therapy (CBT), cognitive processing therapy (CPT), brief eclectic psychotherapy (BEP), eye movement desensitization and reprocessing (EMDR), virtual reality graded exposure therapy (VR-GET), and resilience-oriented treatment (ROT).Conclusions:This systematic review showed that psychological treatments for PTSD do not affect most neurocognitive functions, with exception of the memory outcomes. Future research, high-quality studies are needed to provide evidence of the effect of psychological treatment in improving neurocognitive functioning in PTSD.HIGHLIGHTSThis systematic review investigated the effects of psychological treatments on neurocognitive functioning in adults with PTSD.This review showed that most studies were very heterogeneous in design, method, and analysis.This review supports the evidence for psychological treatments for PTSD on improving memory outcomes.

Evidence from both human and preclinical studies seems to indicate that maternal smoking, alcohol drinking, or other drug use during pregnancy can affect offspring outcomes. It also suggests that maternal substance use during pregnancy is a major preventable cause of adverse infant outcomes. Nonetheless, more recent studies applying genetically sensitive designs cast some doubt on the causality of the relationship between prenatal maternal substance use and infant and child behavioral outcomes. In this review, recent findings in this field of research are provided, with attention to correlated risk factors of maternal substance use during pregnancy and preclinical studies focusing on plausible biological pathways. Next, evidence-based interventions targeting maternal substance use during pregnancy are discussed. Finally, possible interventions targeting the correlated risk factors and recommendations for clinical work are presented.

Two new trends in adolescent substance use have emerged: e-cigarette use and nitrous oxide (N20) use. E-cigarettes are often tried out before traditional cigarettes, are easily available and regarded as harmless by adolescents. Studies increasingly show negative health effects of regular e-cigarette use, including the risk of becoming a smoker of traditional cigarettes and nicotine addiction. N20 use has also become increasingly popular, and follows after cannabis and ecstasy use in prevalence rates. As with e-cigarette use, most users are not aware of potential health risks of N20 use, while particularly longer-term and heavy use may yield negative neurological and psychiatric effects. The misconception of risks, and high availability of both inhalants warrant better education to prevent poor outcomes.

The last decades, an increasing literature on prenatal influences on child behaviour, including temperament, has emerged. This review will give an overview of animal and human studies that have focused specifically on the relation between prenatal stress exposure and offspring behaviour or temperament in early life. The concept and assessment of prenatal stress in animal and human studies is described, and biological responses to stress exposure in humans are discussed. Furthermore, potential mechanisms related to prenatal stress exposure and offspring behaviour are summarized. Findings of both animal and human studies suggest that adaptation to novelty, altered attention, and increased emotionality may be the result of in utero exposure to stress. Although the effect sizes of most studies are rather small, these variations in behaviour could be a risk factor for later psychopathology.

This study examined specific and general psychological distress 8.5 years following the 1992 cargo aircraft crash in Amsterdam. Participants included 334 occupationally exposed fire fighters and 834 occupationally exposed police officers compared with reference groups of 194 fire fighters and 634 police officers who were exposed to duty-related stressors other than the disaster. On the standardized instruments of psychological distress, exposed fire fighters reported more somatic complaints and fatigue, while exposed police officers reported higher psychological distress on all aspects. The degree and type of exposure at the disaster site and other background factors were associated with several outcomes of psychological distress levels of exposed rescue workers. The disasters’ aftermath of rumors about potential health consequences due to toxic exposure likely contributed to the long-lasting psychological distress of some of the rescue workers as well.

OBJECTIVE: To investigate whether using ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is preceded by symptoms of behavioural and emotional problems in childhood and early adolescence. Design Prospective, longitudinal, population based study Setting The Dutch province of Zuid-Holland. Participants A sample of 1580 individuals, followed up across a 14 year period, from childhood into adulthood. MAIN OUTCOME MEASURES: The first assessment took place in 1983 before MDMA appeared as a recreational drug in the Netherlands and included the child behaviour checklist to obtain standardised parents' reports of their children's behavioural and emotional problems. Use of the drug was assessed with the composite international diagnostic interview 14 years later. RESULTS: Eight syndrome scales of childhood behaviour were examined. Scores in the deviant range for the scales designated as anxious or depressed in childhood were significantly related to use of MDMA in adolescents and adults, resulting in an increased risk (hazard ratio 2.22, 95% confidence interval 1.20 to 4.11, P = 0.01). CONCLUSIONS: Individuals with childhood symptoms of anxiety and depression may have an increased tendency to use MDMA in adolescence or young adulthood. Its effects are supposed to include enhanced feelings of bonding with other people, euphoria, or relaxation. Especially individuals with symptoms of anxiety or depression may be susceptible to these positive effects.

Objective : We examined whether psychological and endocrinological measures of stress during pregnancy predicted developmental outcome of human infants in a prospective design. Methods : Self-report data about daily hassles, pregnancy-specific anxiety and perceived stress, salivary cortisol levels and adrenocorticotropic hormone (ACTH) levels were collected in nulliparous women throughout pregnancy. Infant development was measured at 3 and 8 months by means of the Bayley Scales of Infant Development (BSID). Infant temperament was rated by means of observed behavior and maternal report. Results : High levels of pregnancy-specific anxiety in early pregnancy predicted both temperamental and developmental difficulties. High amounts of daily hassles in early pregnancy were associated with lower mental developmental scores. Perceived stress in early pregnancy was related to more difficult behavior and adaptational problems. Early morning values of cortisol in late pregnancy were negatively related to both mental and motor development, whereas higher ACTH levels were related to more adaptational problems. All results were adjusted for a large number of covariates. Conclusion : Increased maternal prenatal stress seems to be one of the determinants of temperamental and developmental variation of infants. The hypothalamic-pituitary-adrenal (HPA) axis may be involved in the harmful effects of prenatal maternal stress on infant development and temperament.

ABSTRACTBackground: Syrian refugees face multiple hardships and adversities which put them at risk for the development of mental health problems. However, access to adequate mental health care in host countries is limited. The WHO has developed Problem Management Plus (PM+), a brief, scalable psychological intervention, delivered by non-specialist helpers, that addresses common mental disorders in people affected by adversity. This study is part of the STRENGTHS project, that aims to evaluate peer-refugee delivered psychological interventions for Syrian refugees in Europe and the Middle East.Objective: To evaluate the effectiveness and cost-effectiveness of the peer-refugee delivered PM+ intervention among Syrian refugees with elevated levels of psychological distress in the Netherlands.Methods: PM+ will be tested in a randomized controlled trial (RCT) among Arabic-speaking Syrian refugees in the Netherlands aged 18 years and above with self-reported psychological distress (Kessler Psychological Distress Scale; K10 >15) and impaired daily functioning (WHO Disability Assessment Schedule; WHODAS 2.0 >16). Participants (N = 380) will be randomized into care as usual with PM+ (CAU/PM+, n = 190) or CAU only (CAU, n = 190). Baseline, 1-week post-intervention, and 3-month and 12-month follow-up assessments will be conducted. Primary outcomes are symptoms of depression and anxiety. Secondary outcomes are functional impairment, posttraumatic stress disorder symptoms, self-identified problems, anger, health and productivity costs, and hair cortisol concentrations. A process evaluation will be carried out to evaluate treatment dose, protocol fidelity and stakeholder views on barriers and facilitators to implementing PM+.Results and Conclusions: PM+ has proved effectiveness in other populations and settings. After positive evaluation, the adapted manual and training materials for individual PM+ will be made available through the WHO to encourage further replication and scaling up.Trial registration: Trial registration Dutch Trial Registry, NL7552, registered prospectively on March 1, 2019. Medical Ethics Review Committee VU Medical Center Protocol ID 2017.320, 7 September 2017.